Can I take Atorvastatin and Levothyroxine together?

Why this happens

Atorvastatin may slightly interfere with the proteins that carry thyroid hormone in your blood, potentially increasing the amount of active levothyroxine. Additionally, if your thyroid condition is not well-controlled (hypothyroidism), it can naturally raise your cholesterol levels, making the statin appear less effective.

What you should do

You can take these medicines together. However, you should have your thyroid function (TSH levels) monitored regularly by your doctor, especially when starting or changing the dose of atorvastatin. If you notice symptoms of an overactive thyroid, such as a racing heart, feeling unusually hot, or tremors, inform your GP.

Important precautions

Pregnancy

You must not take atorvastatin if you are pregnant or planning to become pregnant, as it can cause serious harm to an unborn baby. Use effective contraception while taking this medicine.

Muscle disorders - atorvastatin

Seek immediate medical advice if you experience unexplained muscle pain, tenderness, or weakness. In rare cases, this can lead to a serious condition called rhabdomyolysis which causes kidney damage.

Heart conditions (e.g. angina, heart failure)

If you have a heart condition, your dose must be started very low and increased slowly. Contact your doctor immediately if you experience chest pain or palpitations, as levothyroxine increases the workload on your heart.

Interaction with supplements (Calcium/Iron)

Do not take calcium tablets, iron supplements, or multivitamins at the same time as levothyroxine. You must leave a gap of at least 4 hours between these supplements and your levothyroxine to ensure the medicine works.

Diabetes

Levothyroxine can raise blood sugar levels. If you have diabetes, you must monitor your blood glucose more closely when starting or changing your dose, as your diabetes medication may need to be increased.

Food and drink warnings

Alcohol

While alcohol does not directly interact with atorvastatin, drinking large amounts of alcohol can increase the risk of liver problems and muscle side effects. It is best to keep your intake within the recommended limits (no more than 14 units per week).

It is best to avoid or strictly limit alcohol while taking levothyroxine. While there is no direct chemical reaction, alcohol can affect thyroid function and may worsen symptoms like tiredness or mood changes.

Timing of dose

Levothyroxine must be taken on an empty stomach, at least 30 to 60 minutes before breakfast or any caffeine, as food and drink significantly prevent it from being absorbed.

Grapefruit juice

Grapefruit juice contains compounds that can increase the level of atorvastatin in your blood. This may increase your risk of side effects, such as muscle pain or damage. Avoid drinking large quantities (more than 1.2 litres per day), though it is safest to avoid it altogether or keep intake to very small amounts.

Dairy products (Milk and Yoghurt)

Calcium found in dairy products can interfere with how your body absorbs levothyroxine, making it less effective. You should avoid eating or drinking dairy for at least 30 to 60 minutes after taking your medicine.

Caffeine (Coffee and Tea)

Caffeine can significantly reduce the absorption of levothyroxine. You should wait at least 30 to 60 minutes after taking your tablet before having a coffee or tea.

Soya products

Soya can stop your body from absorbing levothyroxine properly. If you eat a lot of soya, your doctor may need to monitor your hormone levels more closely.

Papaya

There is some evidence that eating large amounts of papaya can interfere with how levothyroxine is absorbed.

Kelp and Seaweed

These foods are naturally high in iodine. Too much iodine can interfere with your thyroid treatment and make your condition worse.

High-fibre foods

A diet very high in fibre can reduce the absorption of levothyroxine. If you significantly change your fibre intake, inform your doctor as your dose may need adjusting.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.